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psoriatic Arthiritis

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I suspect I have this and will be going for a check up next friday.

had psoriasis in my 20's but no flare up for a long time. The

arthritis is creepingly getting worse and now am trying to determine

if I can get medical help with pain or if I need to get different job

or what. How is it diagnosed? Blood tests or medical history or what?

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Bonita, what kind of doctor are you seeing for your check-up? Ask him

to refer you to a rheumatologist. They are more knowledgeable than

other doctors about PA and most likely to recognize it. There are no

slam-dunk tests for PA; it is diagnosed based on clinical symptoms.

The classic symptoms are joint/tendon pain with a history of current or

past psoriasis. You may or may not have elevated inflammatory markers

in bloodwork. You hopefully WON'T have any actual joint damage that

will show on x-ray because it takes many years in most cases (thank

God) for that to occur.

If you have any of the following additional symptoms, you should be

sure to mention them:

jaw pain

eye pain or other eye problems including blurred vision

pain in the chest, particularly upon taking a deep breath

pitted, peeling, or crumbly finger- or toe-nails

unusual fatigue

daytime drowsiness

insomnia

falling down due to weak or turning ankles

dropping things due to weakness in fingers or wrists

joint stiffness, especially in the morning or after sitting or lying

swelling of one or more fingers or toes, or swelling of joints

Others may add some I haven't thought of. These sometimes subtle

symptoms may add additional weight to a suspicion of PA.

best wishes,

sherry z

>

> I suspect I have this and will be going for a check up next friday.

> had psoriasis in my 20's but no flare up for a long time. The

> arthritis is creepingly getting worse and now am trying to determine

> if I can get medical help with pain or if I need to get different job

> or what. How is it diagnosed? Blood tests or medical history or

what?

>

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Hi Sherry,

You sound knowledgeable and experienced and I feel desperate to

contact people who know what this is all about. I have recently been

diagnosed with PA and initially simply didn't want to accept the

diagnosis. However, as the swelling in my toes is getting worse and

involving more than just one toe on each foot and now that the

fingers of my left hand have also begun I have to fact the fact that

I (might) have PA. For a long time I have had stiffness after

sitting and sensitivity in my feet on waking. All of which is

getting worse. But following three attacks of gout in my small toe

on one foot I had an attack which was different and on both feet

involving the small toe but my baby finger also began to swell and

become red and tender. All my finger nails and toe nails became

ultra-sensitive in the corners and I could not touch the tips of my

toes or fingers. Following a few months of this it began to ease and

I began to walk almost normally however I have had to buy bigger

shoes and soft socks - my ordinary shoes and socks are unbearable.

Slowly it lessened and I began to think that maybe the rheumatologist

was wrong. But three day ago the whole thing began to flare and I

realise that it is now affecting more toes and fingers and not

responding to anti inflammatories.

From your experience does this sound like PA and are my symptoms

typical? The next question which I am even scared of asking is what

are my future prospects with this disease? Can you or someone out

there tell me what to expect as this disease progresses, how do you

accept it and find a way of living with it and is there any way of

slowing it down? I realise these are hard questions but I'd like to

hear from different people so as to get as wide a picture as possible.

Many thanks,

Patrice.

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Hi Patrice,

A couple of things here.

Why might you think your Rheumy is wrong??? Or are you experiencing

some denial??

You have described some very classic symptoms.

As far as a prognosis... You are seeing a rheumatologist. GOOD.

Now, what has your rheumy prescribed as treatment?? Then, Are you

doing it??

PA is not a " death sentence " . It doesn't even need to mean that your

life is going to change dramatically. Yes, you may need to start a

course of treatment and it may take trying a few different drugs

until you find what works for you.

While I have only been diagnosed with PA for 5-6 years,I can tell you

that my life has changed. Prior to being diagnosed, I had multiple

sausage fingers & toes, swollen elbows and knees. I was barely able

to walk. I had constant pain, I slept painfully and fitfully for only

a few hours each night.

Today, I take 10-12.5 mg of Methotrexate a week.

I am 98% normal, more active than before I had PA Symptoms. All of my

joints are normal. I rarely experience any joint pain.

Yes, I have had a flare up or two, But I feel that I " caused " them in

some part, by overdoing something or continuing to do something even

though I could start to feel the pain.

So my message: " Your life can continue mostly normal, probably better

than you feel right now, but ONLY if you start treating your disease

immediately. " The longer you delay, the longer you allow it to

progress, the more apt you are to experience permanent joint damage.

No drug will ever fix that. Surgery may, but I think that is a choice

that you'd rather not need to make.

Stay Well,

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Patrice, yes it does sound like PA and your symptoms follow a pretty

typical pattern - including the fact that it gets better or goes away

for awhile then comes back.

Your future prospects are quite good provided you get the proper

treatment. The DMARD drugs (disease-modifying anti-rheumatic drugs)

which include methotrexate, Enbrel, Humira, Remicade, and others I'm

not as familiar with actually slow or stop the progression of the

disease. They can even induce a complete remission. I'm currently

taking Humira. It has helped greatly. I'm hopeful that I will

continue to improve and that the flares will become shorter, milder,

and with longer periods between. That hope is AWESOME because 2

years ago I had no hope at all - I thought my life was as good as

over.

One of the best results is that now when I have a flare I don't

panic. I just go to bed, take pain pills and double anti-

inflammatory, and wait for it to pass. Even if it lasts for weeks,

it will eventually pass and life will get closer to " normal. " Just

knowing this really helps me to endure.

What drugs has your rheumy put you on? If you are only taking anti-

inflammatories, discuss with him the DMARD drugs and ask to be

started on them.

Keep your chin up - it will get better.

sherry z

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greetings....well, you are your way to a big trouble. if to not get prepare

treatment, you will loose your toe cartilage, and this no fun at all, talk to

your RA to be on mtx......blessed be,,,,bob

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